Friday, February 09, 2007

The Search for the Magic Bullet

"I can't sleep. I sleep maybe four hours every night. If I go to bed at midnight, I get up at four. If I go to bed at four I get up at seven. It's crazy." She rolls her eyes in disgust.

"Well, there's a program we can send you to where they teach you how to sleep better," the kindly doctor says. "It's called sleep hygeine."

"It works for alot of people," I add. "Medications often don't do enough."

"No way," she replies vehemently. "I know my body, I know my brain. I just can't sleep. All I need is a pill to make me sleep." She crosses her arms. The doctor and I exchange glances.

"What do you do when you can't sleep?" He looks at her and then at me.

"Watch TV."

"You watch TV. Anything else?" I ask.

"Oh yeah, I smoke." There's silence in the room.

"How about your back?" the doc asks, changing the subject. "Is that any better?"

"Nah," she retorts. "It's worse. Hurts all the time. If I sit it's OK, otherwise it's torture. The muscle relaxants don't help either."

"How about the methadone?" the doctor asks. (The patient is on methadone three times a day for chronic pain.)

"No, it doesn't help at all. Can I get something else?" She crosses her arms again.

"We'd like to try physical therapy."

"I won't do that! That hurts! My friend says it messed her up!"

The doctor and I smile. "We can direct them regarding what they do. There's massage, cold and heat packs, ultrasound. You might really like it."

"I won't stretch! I know my body. I know that stretching hurts. I just want a pill."

The appointment's going nowhere, and we haven't even talked about her Hepatitis C treatment yet. We're both exasperated. No sleeping pill prescription is forthcoming, and she eventually concedes to a physical therapy referral. Will she go? Probably not.

Everyone wants the magic bullet, a pill to assuage their suffering. Many doctors use that arsenal of pharmacoepia to attempt to do just that, but sometimes we just want some proactive work to be done by the patient, some effort beyond opening a bottle and swallowing a pill. Sure, sleep hygeine education isn't anyone's idea of a good time, but what good is a pill when the patient has no inkling of how to properly prepare for a good night's sleep? We frequently dance along the edge of enabling such passive behavior. Of course we may give in at times, but sometimes we just say no to the easy way out.

2 comments:

Eric said...

Ah….the sweet, smell of perfume! Today's market is flooded with hundreds and hundreds of different fragrances ranging from floral to woodsy. Most women love the smell of perfume, wearing it even when going to the grocery store. The problem is that perfume allergy for some women, is anything but nice.

Anonymous said...

101 ways to get good night sleep

1.The bedroom should not be too hot or too cold. High temperatures can lead to disturbances in the quality of sleep. The optimum temperature is 60 to 65 degrees Fahrenheit. If the room is too cold, use humidifier or warm blankets.

2.Don’t discuss about the bills or problems or watch television in the bedroom.
3.Drinking warm milk before going to bed helps in soothing the nervous system. As milk contains calcium, it works on the nervous system and makes the body relax.

4.Sleep on back as it allows all the internal organs to rest properly and it is the best position for relaxing.

Rests of 101 ways are……...

http://www.sleepdisordersguide.com/blog/good-night-sleep-101-ways/